Targeted EHR Messages Can Decrease Unnecessary D-Dimer Tests for Elderly

Researchers from Kaiser Permanente in Denver have concluded that targeted age-specific computerized alerts can reduce the number of D-dimer testing needed in elderly patients, according to the study’s abstract.

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The D-dimer test is used to diagnose deep vein thrombosis and pulmonary embolism. However, the negative predictive value of the test worsens as patient age increases, and the overall accuracy of the test is only 35 percent for patients 65 years and older.

Kaiser Permanente researchers identified eight primary care clinics with at least 3,000 patients aged 65 years or older at each facility. Half of the participants were assigned to a control group, and the other half was assigned to an intervention group. When physicians would order the D-dimer test for elderly patients, Kaiser’s electronic health record system would send an alert notifying the physicians that the test was inaccurate and suggesting they conduct a radiology test instead.

Results from the study showed the electronic age-specific EHR alert to a specific condition reduced the number of D-dimer tests ordered for elderly patients in the outpatient setting by 70 percent.

Read The American Journal of Managed Care’s article “Computerized Alert Reduced D-Dimer Testing in the Elderly.”

Read other coverage about electronic alerts:

UPenn Study: Computerized Order Entry System May Come With Unintended Results

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